(WOMENSENEWS)–Nancy Gleeson never said “no.” When she saw sugar, she ate it, gorging on cookies, chocolate and banana splits every day for decades. She didn’t worry about the weight gain that left her tipping the scales at 225 pounds. She didn’t heed the family history that put her at high risk for diabetes–until she wound up in the emergency room with debilitating fatigue and a blood sugar level that was triple the norm.
“I didn’t realize I had to take care of my body until it was nearly too late,” says Gleeson, a Tulsa, Okla., mother and one of 9 million American women who have diabetes.
Exacerbated by the rise in obesity and increasingly sedentary lifestyles, diabetes has soared to record levels in the United States. This disease affects women differently than men, as only women develop gestational diabetes and as women are more likely to develop complications like damage to the nerves and heart. Women of color are especially at risk, with double the likelihood of developing the disease. Since women are in greater danger of getting diabetes, health experts are reaching out to women in the hope that they will help stem the tide of this health epidemic.
“This disease is a silent killer,” says Cathy Tibbetts, president of health care and education for the American Diabetes Association, based in Alexandria, Va. “Though 8.7 percent of American women have diabetes, a third of them don’t realize they are affected.”
Tibbets says that because diabetes can develop gradually with no obvious outward signs–and because Americans have such poor health habits–the disease has become the sixth leading cause of death among women in the U.S. today.
Health Choices Fuel Diabetes Crisis
Diabetes is a disease in which the body fails to produce or process insulin, a hormone that is manufactured by the pancreas and helps convert food into energy. Over time, diabetes causes glucose or sugar to accumulate in the bloodstream instead of being used for fuel. This buildup causes excessive thirst, frequent urination and physical exhaustion. It can also wreak havoc with the whole body, which is why diabetes often comes hand in hand with secondary complications like heart, eye and kidney disease.
Depending on the symptoms and age of onset, diabetes can fall into one of two categories. Type 1, in which the pancreas makes little or no insulin, usually strikes in childhood and can be treated with injectable insulin. Type 2, in which the body is resistant to insulin, usually strikes in adulthood and can be treated with prescription medication. Though both types are affected by genetic predisposition, health habits are more likely to trigger type 2 than type 1.
In recent decades, the incidence of type 2 diabetes has spiked dramatically not only among adults, but also among young people. Since excess fatty tissue makes the body more resistant to insulin–and since 45 percent of children and 35 percent of adults in the U.S. are overweight–widening girths have put Americans at higher risk for type 2, which now accounts for 95 percent of diabetes cases. Since more women in the U.S. are overweight than men, women face a greater likelihood of developing type 2.
In Gleeson’s case, weight gain caused her to acquire type 2 decades earlier than her mother and grandmother, who also suffered from the disease. Though much of the damage to Gleeson’s body is irreversible, she now controls her condition by shunning sugar, walking daily and staying 45 pounds slimmer than she was when first diagnosed.
Female Diabetics Have Unique Needs
Though diabetes affects men and women in equal numbers, women’s concerns when it comes to this disease are especially pressing. Conditions like polycystic ovarian syndrome can increase the risk of developing either type 1 or type 2. Also, pregnant women run the risk of giving birth to an unusually large infant weighing nine pounds.
If a woman as little as ten pounds overweight before pregnancy, she could develop gestational diabetes, in which the hormones produced by the placenta interfere with insulin production in the mother. Affecting 4 percent of pregnancies in the U.S., gestational diabetes can increase the likelihood for a woman to develop type 2 diabetes later in life.
If a woman already has diabetes, gender differences can complicate her treatment. Women experience more fluctuations in the level of the hormone estrogen, which makes cells more receptive to insulin and thus lowers blood sugar. Thus, during the course of the menstrual cycle, female diabetics must monitor their glucose levels more carefully. And female diabetics are more likely than male diabetics to develop secondary complications such as cardiovascular disease and reduced blood flow to the hands and feet, though health advocates are not yet sure what accounts for this gender difference.
Studies show that women of color are at higher risk than white women. Due to a combination of genetic and lifestyle factors diabetes is twice as common among African American and Latina women, who are also more likely to experience eye problems and kidney failure.
No Two Cases Alike
Part of what makes treating diabetes so difficult is that no two cases are alike. Take Gina Gavlak and Lycynthia Baskin. Both were diagnosed with type 1 in childhood, and both have spent the past three decades working to manage their disease. Both prick their fingers and test their blood sugar levels six times a day, and both wear an insulin pump to keep their glucose levels stable.
Each woman exercises, eats well and follows the ABCs of diabetes treatment: “A” for an A1C blood test every three months, “B” for keeping blood pressure levels low, and “C” for maintaining healthy cholesterol levels.
By taking these precautions, Gavlak, an emergency room nurse in Cleveland, Ohio, has been able to manage her diabetes with relative ease, working 12-hour shifts and still finding the energy to shuttle her two children to drama and gymnastics classes.
Baskin, a stay-at-home mother in Jonesboro, Ga., hasn’t had it so easy. Over time, she has developed a host of secondary symptoms including kidney disease, thyroid disease and vision problems that have left her blind in her right eye. Too exhausted to keep her job at a local bank, Baskin has been on disability since 1999 and needs daily naps to keep up with her 9-year-old daughter. She now takes 14 medications per day and spends $10,000 per year on medical supplies.
Authorities Address Diabetes Epidemic
Baskin’s health costs are just a drop in the bucket of diabetes’ total expense. Costing American taxpayers $132 billion a year, diabetes accounts for 1 of every 10 dollars spent on health care in the U.S.
The government is working to lower this expense. Last year, the U.S. Department of Health and Human Services launched a public education campaign called the National Diabetes Action Plan. And starting this month, Medicare is giving all new recipients free diabetes screenings when they enroll.
Authorities hope to help not only the 18 million Americans who already have diabetes, but the 41 million with pre-diabetes: elevated blood sugar that puts them at risk for the full-fledged disease.
Health advocates are also holding out hope for new treatments including stem cell therapy and an inhaled form of insulin.
Experts say that while these treatments are promising, beating diabetes comes down to the individual–especially individual women. Diabetes Web sites and public service campaigns are targeted at women for social as well as statistical reasons.
“In most families, women are the ones who decide what kind of food goes on the table,” says Tibbetts. “They decide when and how their families exercise. As women, we have the opportunity–and the responsibility–to protect ourselves and our families from this health epidemic.”
Molly M. Ginty is a freelance writer based in New York City.
For more information:
American Diabetes Association: